The first thing I want to address is the Missouri Medicaid expansion. I have addressed this in the past but it appears as if some groups are employing robo calls and scare tactics to bring pressure on the Legislature and it seems like a good time to try once again to explain what is going on.

Going back a couple of years, when the Affordable Care Act was being proposed, the proponents of the act needed to find the money to make it possible to provide "free healthcare." You see, nothing is free, someone has to foot the bill! The proposal was that Medicaid would be expanded within the states and those new recipients of Medicaid would be receiving the "free healthcare" and the states would pick up the additional costs. As you can well imagine, this was met with outrage by the states, many of whom are in as bad a shape as the Federal Government.

Later on when the Supreme Court was asked to rule on the constitutionality of the Affordable Care Act, they said that the Feds CANNOT force the states to expand Medicaid. This prompted healthcare organizations, who had made agreements to take less federal money for DSH payments in anticipation of adding 300,000 new Medicaid patients statewide, to organize a push to change the legislator's minds about expansion. Now, in all fairness, the Feds have promised to pay for the expansion for the next three years but with a $16 trillion debt, how long do you think that promise is good for?

The Governor has been flying around the state (in his new $5.7 million jet) saying that we will take back the expansion if the Feds back out. Are you kidding me? Try taking something like that away from 300,000 people! So, what is the answer? Everyone agrees that affordable healthcare is needed but we need to rework the system we have now before we add new people to the program. By not rushing to join the "new programs", we can work toward Patient Centered Reforms such as are currently working in Louisiana, Kansas, Texas, Wisconsion, and Utah.

We have adequate time to set up a State Exchange well ahead of the deadlines and I think we owe it to the people of Missouri to avoid an extremely expensive program that will have to get its financing from schools, roads and police. The only other option is huge tax increases and no one is calling me and asking for those. We will work toward the best possible options.

We have all the info from our survey tabulated. A GREAT BIG THANK YOU to everyone who took the time and effort to respond. I got back nearly three times as many surveys as my first mailing two years ago. Some of the results surprised me but on the whole, I think we are just conservative thinking citizens. Nearly 64 percent of you think that we should control our own Health Care Exchange. Only 23 percent think we should let the Federal Government take a large role in the process. Surprisingly enough, 47 percent answered that we should not put an exchange in place period and 32 percent responded that we should expand Medicaid if it means the state will only pick up a small share of the expense. Seventeen percent agreed to Missouri paying a larger share than originally promised. Sixty-five percent replied that we should not expand Medicaid under any circumstances. On the subject of Paycheck Protection, 78 percent responded that we should implement the law, 21 percent feel that the current system works well enough. The questions on teachers salaries was pretty well split. Fifty percent responded that teachers should remain on the current step based system while 66 percent favor a merit based system. Fifty percent believe that teachers deserve an annual increase regardless of the system. On Medical Malpractice, 65 percent of you believe that the Legislature needs to reinstate the $350,000 cap, 62 percent of you would like that question to come before the voters and only 25 percent think we are better off without caps.

Page 2 of 2 - Many of you added comments to your surveys and I have read every one of them. I have to admit, some comments were less than flattering, but I really appreciate knowing that you don't agree with me. My intent is to do the will of the majority of my constituents, but each and every voter is entitled to their opinion and more than once I have changed my personal opinion after talking to one of you about a proposal before the Legislature. I'm glad to say that the good comments outnumbered the bad ones by quite a bit. Don't worry, Jane won't let me get a big head! She does a pretty good job of keeping me in my place. We have a lot of work ahead of us now that break is over, I'll report more next time. Until then, I am and remain, in your service.

Bill Lant

417-437-8223

bill.lant@house.mo.gov

573-751-9801

Bill Lant represents the people of Southwest Missouri in the Mo. House of Representatives. Contact him locally at 437-8223 or at his Jefferson City office at (573) 751-9801 or email him at bill.lant@house.mo.gov.